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Title: Hepatic portal venous gas in Crohn's disease.
Austin Authors: Cunningham, Georgina;Cameron, Georgina;De Cruz, Peter
Affiliation: Department of Gastroenterology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia
Issue Date: 26-Sep-2014
Publication information: BMJ Case Reports 2014; 2014: bcr-2014-206244
Abstract: Hepatic portal venous gas (HPVG) is a rare finding that has only been reported previously among 25 patients with Crohn's disease in the English literature. We present a case of a 27-year-old woman with Crohn's disease who presented with fever, abdominal pain and per rectal bleeding and was found to have HPVG at the time of presentation most likely due to an enterovenous fistula. She was managed with intravenous antibiotics, corticosteroids and infliximab and subsequently made a full recovery. HPVG is most likely a manifestation of penetrating Crohn's disease, is overall associated with a low mortality rate and can be managed conservatively in the majority of cases associated with Crohn's disease. Although surgery has been suggested for cases of enterovenous fistulae in the past, this is the first case to suggest that use of antitumour necrosis factor therapy may arrest associated gastrointestinal bleeding and avoid the need for surgery.
Gov't Doc #: 25260428
DOI: 10.1136/bcr-2014-206244
Journal: BMJ Case Reports
Type: Journal Article
Appears in Collections:Journal articles

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